Public Act 17-131 became effective 7/1/2017. This public impacts prescribers in the following ways.
- Limits opioid prescribing for minors to a 5 day supply of medications.
- Requires education for adult or minor patients that are prescribed an opioid drug regarding the risks associated with such opioid drug including but not limited to the risks of addiction and overdose associated with opioid drugs and the danger of taking opioid drugs with alcohol, benzodiazepines and other central nervous system depressants, and the reason the prescription is necessary, and if applicable with the custodial parent, guardian or other person having legal custody of the minor if such parent, guardian or other person is present at the time of issuance of the prescription.
- Requires electronic prescribing of controlled substances (see Electronic Prescribing of Controlled Substances for more information)
Public Act 16-43 became effective 7/1/2016. This Public Act impacts prescribers in several ways.
- Practitioner's authorized agent,
licensed or unlicensed, may register for their own CPMRS user account.
- Whenever a prescribing practitioner prescribes greater than a 72-hour supply of any Schedule V controlled substance for the treatment of any patient, such prescriber, or such prescriber's authorized agent, shall review, not less than annually, the patient's records in the CPMRS.
- Initial prescription for an opioid drug to an adult for outpatient use is limited to a 7-day supply.
- Opioid prescriptions for minors shall not exceed a 7 day supply.
- However, practitioner may exercise medical judgment to determine if the patient's medical condition warrants more than 7-day supply (e.g. severe, acute medical condition, chronic pain associated with cancer diagnoses or for palliative care). This must be carefully documented in the patient’s medical record by the practitioner and should indicate that an alternative to the opioid drug was not appropriate to address the medical condition.
Public Act 15-198 became effective 10/1/2015.
Prior to prescribing greater than a 72-hour supply of any controlled substance (Schedule II - V) to any patient, the prescribing practitioner or such practitioner's authorized agent shall review the patient's records in the CPMRS at https://connecticut.pmpaware.net.
Whenever a prescribing practitioner prescribes controlled substances for the continuous or prolonged treatment of any patient, such prescriber, or such prescriber's authorized agent shall review not less than once every 90 days, the patient's records in the CPMRS.
If the CPMRS is not operational, prescriber may prescribe greater than a 72-hour supply of a controlled substance to a patient during the time that the system is down as long as the prescriber or prescriber’s authorized agent reviews the records of the patient in the CPMRS not more than twenty-four hours after regaining access to the system.
Public Act 13-172 was signed into law on June 21, 2013 and became effective immediately. This Public Act will have two direct effects on prescribers in the state of Connecticut.
- MANDATORY REGISTRATION
- All prescribers in possession of a Connecticut Controlled Substance Registration issued by the State of Connecticut, Department of Consumer Protection, will be required to register as a user with the Connecticut Prescription Monitoring and Reporting System (CPMRS) at https://connecticut.pmpaware.net.
- MANDATORY REPORTING
- Any prescribers who dispense controlled substances from their practice or facility, etc., will be required to upload dispensing information into the CPMRS Data Collection website at https://pmpclearinghouse.net.
Understanding CPMRS Utilization
Access to comprehensive controlled substance prescription records.
Access to controlled substance history report from other states.
Ability to review prescribing history reports to identify possible forgeries.
Access to unsolicited clinical alerts.
Ability to post alerts on particular situations or patients concerning misuse, diversion or abuse of controlled substances. (under maintenance)
Controlled Substance Prescription Records
Patient reports provide prescribers with a comprehensive view of the individual's controlled substance prescription history and contains the following information: Rx written date, Rx filled date, drug description, quantity, days supply, Rx #, prescriber, pharmacy, refills, payment type, daily morphine milligram equivalent (MME), and contact information for prescribers and pharmacies. Reports may be reformatted to a .PDF or .CSV file.
The CPMRS is a healthcare tool that is intended to be used to support prescribers in the treatment of their patients, specifically to detect signs of prescription abuse, addiction, and/or risk of overdose.
Out-of-State Controlled Substance Prescription Records
The CT Prescription Monitoring Program (PMP) participates in an interstate data exchange network. The CT PMP currently shares controlled substance prescription data with other states, including all the border states (RI, MA, and NY).
Prescriber Self Audit Feature to Detect Possible Errors and Forgeries
Prescribers have the ability to query their prescribing history (up to 3 years). This feature allows the prescriber to identify errors and/or forgeries for prescriptions that have been filled under their DEA registration number. If an error and/or forgery is detected, verify your findings by contacting the dispensing pharmacy or the prescriber. Also, please read the FAQs for other optional action steps.
Clinical alerts are indicators of patients that may be at a high risk for an overdose. Practitioners are asked to review the patient's CPMRS report and use it as a tool to determine the appropriate level of care.
- Generated when a specified number of Prescribers and or Dispensers is met or exceeded within a set time period.
Please Note: The CT PMP has set the following threshold: 5 Prescriber AND 5 Pharmacies WITHIN the last 3 months.
- Generated when the daily active MME (morphine milligram equivalent) is greater than or equal to specified values.
- Generated when Opioids and Benzodiazepines are prescribed concurrently.
Empowering CPMRS Users - Posting System Alerts (under maintenance)
The Alert feature that allowed users to post notifications on particular situations or patients concerning misuse, diversion or abuse of controlled substances is temporarily down for maintenance. We apologize for the inconvenience.
Please Note: The State of Connecticut does not warrant the information contained in the patient's prescription history reports to be accurate or complete. The report is based on the search criteria entered and the data entered by the dispensing pharmacy. For more information about any prescription, please contact the dispensing pharmacy or the prescriber.
Prescriber Tips, Resources, and Referrals
For Prescription Opioids or Heroin Addiction treatment call 1-800-563-4086
Things to consider as you talk to your patients:
- Do they have depression or anxiety?
- Do they need pain consultation with a specialist?
- Do they need psychiatric help?
- What treatment options are available?
- Is the problem addiction?
Discussing addiction and abuse with patients can be difficult, but it can lead them to a safer and better way of life.
Patients who are confronted about drug addiction may:
- Deny the accuracy of the information on the report
- Plead or try to bargain with you
- Threaten harm to self or others
- Admit their problem but have no intention of following through on any recommendations
- Try to justify their actions
- Shift responsibility for their behavior to others
These reactions are characteristic of addictive behavior.
Care and Understanding
Patients with drug abuse problems are likely to be frightened and desperate. They may have a distorted concept of their behavior, believe nothing is wrong, or convince themselves that someone else is to blame. As you attempt to defuse arguments and calmly present the facts, you can offer helpful suggestions that may guide your patients into treatment.
Drug abuse is a complex problem. You may want refer to specialty care or consult with an addiction specialist, psychiatrist or pain specialist.
Overdose deaths and addiction related to prescription drugs are a troubling and very real issue. DCP encourages you to use the CPMRS to your advantage to provide safer and better care to your patients.